Management of thoracic duct injuries after oesophagectomy

Abstract

The thoracic duct should be ligated during oesophagectomy. A high index of suspicion for duct injury must be maintained in all patients after operation. A policy of very early thoracic duct ligation at 48 h from diagnosis is proposed for duct injury if aggressive conservative management fails.

Comparison of Early and Late Complications in Three Esophagectomy Techniques

“…If chyle is not stopped, patients will faced immune deficiency, resulting in infection and mortality (35). Some studies have shown the superiority of surgery over conservative treatment (34,(38)(39)(40). Thus, the treatment method of Chylothorax is conservative but when the outlet of the chest tube is more than 800 cc per day and it will continue for 4 to 5 consecutive days, waiting for stopping the leak may be dangerous due to leukopenia and malnutrition; therefore, surgery is required in these circumstances.…”

A Chylous Rupture

“…In scientific terms, the weaknesses of this report are the fact that a rupture of the cysterna chyli was not definitively identified and we did not obtain laboratory confirmation that the fluid was chyle. Little has been published on isolated injuries of this sort [1][2][3][4] . In thoracic duct injuries, however, persistent loss of chyle has serious complications including death 5 .…”

“…When alendronate is given for only six weeks at doses of 5-40 mg per day to postmenopausal women, PTH returns to baseline within as little as three months 1 . Symptomatic hypocalcaemia has been reported in patients treated with alendronate for osteoporosis or Paget's disease, usually because of unrecognized post-surgery hypoparathyroidism [2][3][4] . To our knowledge it has not been described before in the context of vitamin D deficiency and secondary hyperparathyroidism.…”

Seizures after alendronate

“…Foreign bodies in the nose are seen mainly in young children who have inserted them deliberately 1,2 . Batteries are especially troublesome, because of their erosive effects 3 .…”

“…The inert nature of the plastic did, however, mean that there was little tissue reaction of the kind that might have complicated its retrieval. [2][3][4] . To our knowledge it has not been described before in the context of vitamin D deficiency and secondary hyperparathyroidism.…”